tag:blogger.com,1999:blog-5483155357910294002024-03-14T08:05:49.629+00:00In2MotionRichard M Pool Dip SRMT (BTech 5), Cert. PT (REPS 3), Dip. NutritionRichardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.comBlogger77125tag:blogger.com,1999:blog-548315535791029400.post-22034199554489199712018-04-23T07:59:00.000+01:002018-04-23T07:59:09.815+01:00LVMM 2018So this was my 7th year working at the London Marathon and my 3rd year working with Against Breast Cancer. It was, in many ways, exactly the same as most of the previous years. We get up and pack the car with the couch, the kit and lunch. Around 9:30 we set off and drive to the station in Upminster, park in one of the local streets and walk to the station. The couch weighs around 11Kg and then there's a bag with my towels, lotion and tape and my rucksack with a few other things in it. It's probably no more than about another 5Kg but by the end of the day it might as well be another 30! I'm so glad Anne comes with me to help!<br />
<br />
We hop on a District Line train around 10:15 and set off for Westminster station where we use the lifts to get to street level and begin to work our way through the crowds towards St James Park by going up Parliament Street and then heading to Horse Guards via King Charles Street past the Cabinet War Rooms. It's the shortest route, but it also has steps down to Horse Guards Road which are always a challenge withe the trolley. One year I'll go towards Birdcage Walk and see if that's flatter!<br />
<br />
We arrive at St James Park around 11:30 and nip into the cafe for a drink and the use of a proper toilet! If we sit in the right place we can look across the park to the usual pitch where the charity sets up. When we see the flags going up we know we can wander across and meet the team. I say team, it consists of two guys from the charity!<br />
<br />
Once the couch is set up and I've got all my stuff stored away and ready to go it's usually around 12:00 and we start to think about when the first runners might arrive. Even the fastest charity runners don't usually arrive before 1:30 and most come in after 2:00. This year, being the hottest on record, many were much later than expected. We eat lunch, have a wander around and generally wait.<br />
<br />
So from 12:00 to around 2:30 it's mostly waiting around with a few runners, usually club runners, coming in early and asking if they can get a bit of work done on aching limbs. I don't mind doing that because otherwise I'm just sitting around and I'd prefer to be doing something.<br />
<br />
By the end of the day I've usually treated around 12-15 runners and we pack up between 5:30 and 6:00 to head home. The couch and bags seem to have got heavier and most times we just sit on the tube until it reaches Upminster. Occasionally we get off at Tower Hill and jump on the C2C, but to be honest there's no rush and stating on the tube means I don't have to stand up from Fenchurch Street which is what I have to do if we get the train.<br />
<br />
It all sounds fairly routine and a bit boring until you listen to the stories of the runners. There's the elation of having completed the 26.2 mile course, the amazement of the support from the crowds shouting out their name as they run past. Everyone gets cheered home. Then you have the reasons they've run. The family members lost to cancer, the desire to do something to raise money for a charity they often have never heard about until they applied for a charity place. The training or distinct lack of it. The sheer determination and stubbornness to get round the course and not give up. The lost toe nails and blood blisters.<br />
<br />
It is a tiring day, full of uncertainty about who might come through and what you might face. But it's a great day. And that is why I do it. As some of you know, and it might sound like me banging on about it, but I have always volunteered my time. I do it because it's one day a year and it's a simple way for me to bless those folk who've pushed themselves to run a marathon. It's my choice.<br />
<br />
But I would like to see more people volunteering and I've got my vision of a small team working across a group of charities to offer a service to a wider group of runners. While we were there this year the events coordinator for the charity spent some time chatting to other charities who'd set up near us. Some had therapists on hand, some didn't. They all thought the idea of working together was a great idea and hopefully we'll get into conversation about how to do that. But it will require therapists to offer their time and expertise to make it happen. I suspect that will be the hardest part.<br />
<br />
Here's the thing. Volunteering your skills does not undervalue them. Believe me you will be appreciated more than you can imagine. So give it some thought. Drag that couch across town, make the effort. Earn some CPD hours. Stick next year's date in the diary (once it's confirmed) and sign yourself up. Go on, it's only one day.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-5456613901110814122018-02-24T19:07:00.002+00:002018-02-24T19:07:23.104+00:00The Evolution of Biomechanics: A Review
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<span style="font-style: italic; font-weight: bold;">The Evolution of Biomechanics</span><span style="font-weight: bold;">: Stephen Braybrook. Published by DM Press 2016</span></div>
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The
subtitle of the book is: Bringing movement theory back to life, and the book
goes on to detail the fundamentals of current biomechanics with respect to
their origins in the various theories of mechanics and mathematics that
underpin mechanics and engineering in general. Throughout the book the author
raises questions about the continuing validity of these historical
understandings of geometry and maths to human movement.</div>
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Perhaps
the best way to describe the book is that it seeks to start a conversation
about how we understand human movement. It does this by presenting the past and
present of biomechanics and in so doing points out the flaws in our current
thinking. The author declares his intention<span style="mso-spacerun: yes;">
</span>to be:</div>
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<span style="font-style: italic;">to evolve the theory of human
movement to a level where it accurately reflects reality so the way we
understand, describe and experience what is happening in the body is in
alignment, allowing us to connect with the physicality of the body rather than
the theory of movement being an abstract, mathematical pattern. </span>(216)</div>
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Each
chapter concludes with a "Pit Stop Summary" and a series of questions
for reflection. Of course the questions, while intended to be fairly open and
not designed as an examination of whether you have fully understood the
theories and argument presented, inevitably reflect the authors position that
the fundamental principles upon which much current biomechanical thinking is
based is flawed and needs to change. That's okay, because he might just be
right and a rethink might be what is needed.</div>
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Anyone in
sport (I'm an active tennis player and have played rugby and cricket amongst
others for many years) knows that the body doesn't move in simple straight
lines of movement, that it certainly deforms under impact or pressure and is
therefore far from a<span style="mso-spacerun: yes;"> </span>traditional
"rigid body" when it comes to the mechanics of movement. But do these
simple models assist our understanding or hinder it? Is there a better way to
think about movement? That's a question the book seeks to unpick and a question
that the biomechanics community needs to address.</div>
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The
principle that deeply affects our traditional approach to understanding human
movement is the presumption that we are fundamentally mechanistic. In other
words you can treat the body as a machine, or a series of interconnected
machines. Link this with other things like the principles behind levers and how
they do or do not fit with the mechanism of a joint (a lever can't have a joint
in it in the way the arm has the elbow, so is the arm a lever in the
traditional sense of the word?), and the rigid body, lever based, mechanistic
model for human movement seems to come up quite a long way short of a perfect
fit. But then that's the author's point.</div>
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The book
overall is divided into three main sections:</div>
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<br /></div>
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<span style="font-style: italic; font-weight: bold;">The Past:</span></div>
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This
section deals with the historic basis for biomechanics, it's roots in Euclidean
geometry, Descartian mathematics, Newton's theories and a few other notaries of
engineering and mathematics history. It is this foundation in history that has
shaped the representation of movement in terms of levers, points, straight
lines and rigid bodies. You don't need to understand all the intricacies of
these various theories and models to get the picture that these models are
limited. The question that remains to be answered through the rest of the book
is how limited are they and are they doing a disservice to our understanding of
how the human body moves. </div>
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<br /></div>
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<span style="font-style: italic; font-weight: bold;">The Present: </span></div>
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This
section deals with current thinking in the field of biomechanics. It covers
concepts that are applied to human movement such as degrees of freedom,
kinetics and kinematics and continues to address the authors concerns about the
fit, or lack of it, that human movement has with traditional maths and
geometry. </div>
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<br /></div>
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The final
chapter introduces the more recent concept of tensegrity. Is this a move in the
right direction, ie away from a mechanical view and towards something new? You
might hope so, but apparently nit because it too is based around Cartesian
coordinates, Newtonian maths and Euclidian geometry. In other words, it's just
a new way of "beating down the same path with outdated ideologies"
(p159)</div>
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<br /></div>
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<span style="font-style: italic; font-weight: bold;">The Future:</span></div>
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<br /></div>
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The last
three chapters make up the final section of the book. This is where we get the
author's perspective on a new way to think about human movement. Here we come
across ideas like holism, complex and non-linear systems, synergistics,
self-organisation and sub-optimisation.</div>
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<br /></div>
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In the
final chapter we get to the heart of the search for a new paradigm for
understanding human movement. Dispensing with maths, the root of the problem as
far as the author is concerned, he looks for a new model. It is his hope:</div>
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<br /></div>
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<span style="font-style: italic;">that by rewriting the theory and
rules of human movement that we can gain a deeper scientific understanding of
the real nature of movement and provide credibility to a whole host of
principles, methods and movement practices.</span> p169</div>
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The new
paradigm is christened "biokinesis-ontology", and is broken down as:</div>
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<br /></div>
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Biology:
the study of living organisms</div>
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Kinesis:
movement or motion</div>
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Ontology:
the philosophical study of the nature of reality.</div>
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<br /></div>
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This is
not to say we must abandon all physical laws as they are currently applied, but
rather to move beyond an understanding of human movement based solely upon
those laws.</div>
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<br /></div>
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The
downside to the book is that someone needed to proof read it properly. In the
first few pages there are too many errors that make reading the book more of a
challenge than it needs to be. The problem is that these early mistakes mean
that some of the arguments lose their clarity because you end up trying to work
out if there is another grammatical or syntactical error or whether the author
actually meant what was written. Someone with a better grasp of the principles
being discussed and described might well be able to discern and correct minor
errors as they go, but if you are unfamiliar with some of the ideas then you
might just struggle. </div>
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<br /></div>
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The book
wasn't what I was expecting, but then that's not a big problem. I guess I was
looking for something that outlined the development of biomechanics rather than
raising questions concerning the validity of current theories. It was certainly
a challenge to read and stimulating to think about how I think of movement from
a soft tissue therapist's point of view. </div>
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<br /></div>
</div>
</div>
</div>
Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-67902495528510122062018-02-14T15:16:00.001+00:002018-02-15T15:09:45.711+00:00Post-Event Massage Service at The London Marathon<i><b>This is the text of the document I wrote proposing a post-event massage service. I've continued to work on it and this text includes a section about costs that arises from a number of conversations I've had with others.
</b></i><br />
<br />
<div style="font-family: "helvetica neue light"; font-stretch: normal; line-height: normal; min-height: 15px;">
<i style="font-family: "helvetica neue ultralight"; letter-spacing: 1.9px;"><b><span style="color: #3d85c6; font-size: large;">The Idea in Short</span></b></i></div>
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<span style="font-family: "helvetica neue ultralight"; letter-spacing: 1.9px;"><i><b><br /></b></i></span>
<br />
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<span style="font-kerning: none;"></span></div>
</div>
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<span style="font-kerning: none;">The London Virgin Marathon attracts thousands of runners every year. Many run to raise funds for charities. After 26 miles of running it’s great to be able to offer these fund-raising runners the opportunity to have a short sports massage to help ease tired limbs and reduce some or the inevitable post-event soreness that they will experience.</span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">But what do you do if you are either a smaller charity, without the resources, or a charity with only a handful of runners? Our idea is simple: Gather a small team of therapists working with a group of charities to provide a post-event service to their runners.</span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">Rather than work individually we pool our resources and work as a team. Four or five therapist serving up to a hundred runners across maybe six or seven charities. The charities benefit too. Not only can they offer a post-event treatment to their runners, they can work together on meeting their runners after the event and sharing the costs of post-event gifts and refreshments.</span></div>
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<span style="font-kerning: none;">If you think this is interesting then read the proposal in full and let’s turn this idea into a reality.</span></div>
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<span style="font-kerning: none;">Richard</span></div>
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<span style="font-kerning: none;"><b>Introduction</b></span><br />
<span style="font-kerning: none;"><b><br /></b></span></div>
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<span style="font-kerning: none;">Having supported </span><span style="font-family: "helvetica neue"; font-stretch: normal; line-height: normal;"><i>Against Breast Cancer</i></span><span style="font-kerning: none;"> as a Sports Massage Therapist for the last two years at the London Marathon, and having worked at the event for the last six years, I began to think about other smaller charities and their runners. </span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">Larger charities, or charities with large numbers of runners, often have access to a large team of therapists who serve their runners. For example, one charity for whom I’ve worked has over 150 runners in the event. We had a team of 8 or 10 therapists and between us we treated around 120 runners. (Not all runners come for treatment.)</span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">So I began to think about smaller charities who may not have the opportunity to provide a service to their runners and this idea was born. This proposal sets out the principles and basic concept of what might be possible.</span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">Given that not all runners come for treatment I would suggest that a single therapist working for a single charity might expect to treat between 50-75% of the participants. That might mean that it is simply not feasible for your charity to seek the services of a therapist.</span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">What if a single therapist is working for a charity and they have 20 runners in the event. Of those 20 runners, only 12 come for treatment. That probably gives the therapist a reasonable number of clients for the day, but it also leaves room for anything up to 8 more possible treatments. From experience, dependant upon how well grouped the runners are as they arrive, it’s possible to treat as many as 25 runners over a four hour period based on a simple 10 minute post-event massage. </span></div>
<div style="-webkit-text-stroke-color: rgb(0, 0, 0); -webkit-text-stroke-width: initial; font-family: "Helvetica Neue Light"; font-size: 12px; font-stretch: normal; line-height: normal; margin-bottom: 9px;">
<span style="font-kerning: none;">So why not join forces? If 4 or 5 charities with fewer that 25 runners got together we might be able to provide a post-event treatment for more runners.</span></div>
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<b style="color: #367da2; font-family: "helvetica neue";">How it might work</b></div>
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<span style="font-kerning: none;">Let’s assume that each therapist could comfortably manage to treat 15 runners over a 4 hour cycle. A typical post-event massage lasts around 10-15 minutes, and there’s a bit of time cleaning the couch etc before the next treatment. Obviously there is likely to be some degree of congestion as a number of runners arrive at the same time. It is also important to factor in breaks for the therapists. Massage can be hard work, and although we’re all trained to look after our hands, it is quite stressful.</span></div>
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<span style="font-kerning: none;">So, a team of 4 therapists might reasonably be expected to be able to treat 60 runners. If between 50-70% come for treatment, that would suggest that we could cater for up to 120 registered runners.</span></div>
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<span style="font-kerning: none;">If we limited access to the scheme to organisations with 25 or fewer participants, then 5 charities could participate or a greater number if they have fewer registered runners. </span></div>
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<span style="font-kerning: none;"><b>What the charities would need to do</b></span></div>
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<span style="font-kerning: none;">The charities would need to liaise with each other and a designated team leader for the therapists. It would be easiest for there to be one point of contact between the charities group and the therapists on both sides.</span></div>
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<span style="font-kerning: none;">Between them, the charities would provide a suitable marquee to house the therapists, provide any refreshments they wished to provide and offer any expenses they wish. Each charity would probably want to provide their own “goody bags” to their runners, but I’d suggest some sort of partnership arrangement so that each runner gets something similar. Each charity would also display its own branding etc around the marquee.</span></div>
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<span style="font-kerning: none;">Each charity would organise its own ‘meet & greet’ for its runners, although again this might be something that could be done cooperatively. </span></div>
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<span style="font-kerning: none;">The whole idea is to share the load and provide a service to a greater number of runners.</span></div>
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<span style="font-kerning: none;"><b>What the Therapist Group would do</b></span></div>
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<span style="font-kerning: none;">Each therapist would be responsible for bringing their own equipment, food, snacks, water etc to the venue. They would be expected to commit to the day, starting and finishing together.</span></div>
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<span style="font-kerning: none;">Each therapists would provide proof of insurance, First Aid Qualification and Sports Massage Qualification. Any student therapists would be required to provide the same details and a minimum level of training would be expected (On the course I did that would be passing the general massage assessment).</span></div>
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<span style="font-kerning: none;">The group coordinator would gather all the relevant documentation and provide copies to the charities coordinator. They would also supervise the team on the day and organise any pre-event meetings/training that they felt would be helpful.</span></div>
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<span style="font-kerning: none;">The group coordinator would supply consent forms and other administration with respect to treatment.</span></div>
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<span style="font-kerning: none;"><b>Other things to think about </b></span></div>
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<span style="font-kerning: none;">Administration on the day: It is good practise that each runner completes a simple consent form before treatment. If the therapists are busy there may be a need for someone from one of the charities to take responsibility for ensuring that forms are completed and any relevant information passed to the therapist.</span></div>
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<span style="font-kerning: none;">This is not an exhaustive analysis, it’s just the germ of an idea that has been taking root over a few years. There are probably a whole host of things that need to be considered in order to make it work. On the other hand I believe that every person who commits themselves to running 26.2 mile to raise money for the benefit of other deserves the opportunity of a little post-event therapy.</span></div>
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<span style="font-kerning: none;">Getting a team of therapists together might actually be one of the greater challenges, but we shall have to see! </span></div>
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<span style="font-kerning: none;"><b>A Final Word</b></span></div>
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<span style="font-kerning: none;">Each year I’ve worked at the London Marathon it’s been a challenge getting across the city dragging my couch and equipment. I do it because I believe it’s worth the effort to support all the people who have trained hard and campaigned to raise funds for their chosen charity. Each year I meet first-time, (and last-time!) runners. I hear stories about why they’ve chosen to run.</span></div>
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<span style="font-kerning: none;">I’d love to see every charity runner have the option of a post-event massage. They all deserve it. </span><br />
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<span style="color: #367da2; font-family: "helvetica neue"; font-size: 13px; font-stretch: normal; line-height: normal;"><b>Counting the Cost</b></span></div>
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<span style="font-kerning: none;">Since putting this proposal together and sharing it with a number of people it has become clear that we need to put some figures on the cost of providing this service. So here goes!</span></div>
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<span style="font-kerning: none;">The first thing to note is that this is not a free service. There will be costs, and rightly so. Therapists are trained professionals and we ought not to assume that they all will give their time for free. There are also costs involved in travelling, transport, admin and supervision. So it seems right to begin to put some numbers on these things.</span></div>
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<span style="font-kerning: none;">I’m slowly getting a handle on how it works in other situations, and there’s still a lot to learn, but at a basic level there would be a fee to be part of the service. My suggestion is that each charity pays the same to be part of the service, and at the moment I’m thinking this would be around £50-£100. It’s a bit of a guess, and I’m certainly not trying to make money out of this, but I don’t think that it’s an unreasonable amount. Trying to develop a sliding scale dependent upon how many registered runners each charity has just makes the process a whole lot harder and I’m all for simple solutions. My understanding is that a typical cost to a single charity of £200-£300, dependant upon the size of the team, is typical and means that supervisors are appropriately paid for their work and responsibilities. </span></div>
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<span style="font-kerning: none;">Should the therapists get paid? This is a tricky one. Students can’t be paid (although offering expenses is appropriate), but qualified therapists might expect to be paid. I have always volunteered my time freely, but that’s my choice. A typical fee for a paid event would be around £75 for a four hour day. </span></div>
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<span style="font-kerning: none;">My preference would be that all therapists volunteer their time, but we have to accept that some will choose not to do this. I would certainly set this up as a volunteer service initially, but in the longer term we might have to consider paying therapist in order to avoid people pulling out at the last minute because a paid offer came along. </span></div>
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<span style="font-kerning: none;">There are also admin costs to consider. Managing a team of therapists will require time and effort. I’m not sure how you’d quantify this, but it would need to be taken into consideration. First Aid supplies, water, snacks, all might become part of the overall package.</span></div>
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<span style="font-kerning: none;">So, let’s start by assuming that supervisors get paid for their day, and let’s say that they get £250. Let’s also say that there’s a deputy supervisor and they get £150 (future proofing by planning for someone to take over). £400 split between say 5 charities is £80 a charity. That doesn’t sound unreasonable to me, in fact it sounds like very good value!</span></div>
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<span style="font-kerning: none;">Let’s take it one step further and assume we now pay our qualified therapists (remember we might have both qualified and student therapists). If we had a team of 4, and 2 were qualified. At £75 a day, that’s £150.</span></div>
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<span style="font-kerning: none;">I’ve already suggested that 4 therapists could treat up to 120 registered runners if 50-70% come for treatment. If that’s 5 charities, then the cost per charity to pay the therapists is £30. </span></div>
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<span style="font-kerning: none;">That makes the cost in total per charity around £110.</span></div>
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<span style="font-kerning: none;">There's still a lot of work needed to make this happen, but it's far better to get something out there and refine as we go than to try and set up the perfect system with every angle covered. It is, in R&D terms, an iterative process!</span></div>
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<span style="font-kerning: none;">If the numbers rise then clearly so do the costs. But then the numbers rise with rises charity involvement, so there’s no reason to assume that the costs to any charity will every rise above the £80-£110 amount except for inflation increases.</span></div>
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<i><b>There's still a lot of work needed to make this happen, but it's far better to get something out there and refine as we go than to try and set up the perfect system with every angle covered. It is, in R&D terms, an iterative process!</b></i>Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-73044312557448317562018-02-09T09:21:00.000+00:002018-02-09T09:21:46.996+00:00Shedul: Appointment Scheduling SoftwareI tend to do all my scheduling using my iCal calendar. I have one for personal stuff, one for family, one for work and one for admin. It's reasonably efficient and my wife gets to see what's going into my work diary as well as our home and family calendars. It does some weird things, but generally it works okay.<br />
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When it comes to handling clients though it does lack the automation that is offered by a propriety piece of software that sends out confirmations and reminders automatically and even allows online bookings. I'm not overly keen on allowing folk to be able to book online without some form of communication first, but that's because of the range of things in which I'm involved. It would be tedious to have to book everything in one diary just to avoid people booking a therapy session when I've already booked a tennis lesson or I"m making a personal visit to see someone. My working hours are quite flexible, so having direct control over bookings is important. I've also had some shall we say "strange" conversations with prospective clients, who in the end I've turned down.<br />
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The other thing that is a constant annoyance is the "No-Show". I've had one just the other day. A new client was very keen to arrange an appointment so I made room for therm only to find myself sitting around waiting for them to not arrive.<br />
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<a href="https://2.bp.blogspot.com/-FaoBC7l46T8/Wn1kXp7kRZI/AAAAAAAACBg/Qb1k7GuYndU76zRWLDurt0MHSE0QmPQgACLcBGAs/s1600/Screenshot%2B2018-02-09%2B09.05.10.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="146" data-original-width="288" height="101" src="https://2.bp.blogspot.com/-FaoBC7l46T8/Wn1kXp7kRZI/AAAAAAAACBg/Qb1k7GuYndU76zRWLDurt0MHSE0QmPQgACLcBGAs/s200/Screenshot%2B2018-02-09%2B09.05.10.png" width="200" /></a></div>
So when a fellow tennis coach mentioned a system he was trying I thought it might be worth a look. It's called "Shedul" and you can find it <a href="https://www.shedul.com/" target="_blank">here</a>. At the time of writing it's free, and promises to stay that way for those users who sign up now. It offers options for different staff, shifts, opening hours etc.<br />
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You can send reminders and confirmations by text and/or email. In short it does more or less everything you'd expect this sort of application to do. I'm currently playing with it a bit before starting to use on clients.<br />
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There are some things that make it a little cumbersome and time consuming to use. Some might be resolved as the product develops. The biggest drawback is that it doesn't integrate with my iCal calendars. That means I have to spend time putting appointments into both diary systems and that is tedious and open to error. It would be helpful simply to have my iCal calendars populate shedul, but I can see some challenges with that. For example, if I put a visit to a family for a funeral in my diary I don't really want shedul to pick that up and send them a reminder. All I'd want it to do is block out the time, but then how much time? Also, in the same context, the actual funeral would only need to show up as an event. Obviously the software isn't primarily designed for funeral celebrants, and I understand that. I guess the point is that if you work irregular hours that are very flexible, then time management is always going to be tricky.<br />
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On that basis I can see myself using it for therapy clients and maybe for tennis clients. Again there are issues, but that's because I might be trying to make it do something it wasn't designed to do. For instance, if you run a group session and need to cancel it you need to be able to send a group text. Because the software is designed for salons and spas I don't think it can do groups. There might be a way, or a hack that could work. Again it will need a bit of experimentation.<br />
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The thing is, the world is an imperfect place. We're never going to get the perfect solution to an imperfect problem. But anything that can do the simpler stuff well and reduce the frustration of having forgetful clients missing appointments can only be a good thing.<br />
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<br />Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-46588554707781315682018-01-31T13:29:00.001+00:002018-02-14T15:03:34.725+00:00Smaller Charities at the London MarathonLast year I posted a short piece about the germ of an idea to provide post-event massage to smaller charities or more precisely, charities with a small number of runners. Having only a handful of runners makes having a therapist on hand unviable. But what if these groups worked together?<br />
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I put together an idea of how we might be able to provide a service to more of those dedicated fund raisers who pound the streets for 4 or 5 hours. I tried airing this idea with a few folk but go zero response. It didn't even get shared on a therapist's social media page. Obviously no one thought it was a good plan.<br />
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But I still think it's a good idea in principle. So I'm interested to know if anyone also thinks it's a good idea. So here's a link to a pdf of the proposal I put together. maybe one day someone will pick up this thread and all of a sudden we'll have a team. Who knows!<br />
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<a href="https://www.dropbox.com/s/i7rhe3dt7sdnivt/Proposal%20for%20smaller%20charities%20massage%20service.pdf?dl=0" target="_blank">Proposal for Smaller Charities Massage Service at the LVM</a><br />
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<i>Good news. Since posting this I've managed to get some responses and everyone seems to agree that it's a good idea. </i>Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-245915531474846112017-10-01T08:01:00.000+01:002017-10-01T08:01:08.262+01:00Tips for outdoor training in the winterThe gym is dry and temperature controlled, but there’s nothing quite like being outside even when it's cold. Although it might still be mild outside now, it can change rapidly and putting off that run or walk because you can’t find your thermals isn’t really a good excuse!<br />
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So here are a few tips to help you prepare for outdoor training when the temperature drops.<br />
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<b>Prepare your winter training gear.</b> If you’re like me, thermals, gloves, hats and base layers all get stuffed away in the dark corner of the wardrobe or a packed drawer. I keep promising myself that I’ll organise my clothes so that I know what things are in which drawer or cupboard, but it never works! So, before the cold weather sets in, just check that you’ve got what you need, that it’s still in one piece and that it doesn’t need replacing. Don’t forget any hi-vis bits and pieces either. Check your trainers too. There’s nothing worse than being halfway through a winter run, stepping in a puddle only to discover that your trainers aren’t waterproof. Wet socks and shoes can cause problems other than a squelching noise. </blockquote>
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<b>Invest a little more time in your warm-up routine.</b> A cold start can result in injury, muscles, tendons, ligaments and joints don't take kindly to the cold. So make sure you’re you’re ready to go before that first blast of cold air hits your lungs. </blockquote>
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<b>Breathe properly.</b> Learn to breath in through your nose and out through your mouth. That way cold air takes longer to get to your lungs and consequently is warmer and more moist than if you breathe through your mouth. It also means that your mouth doesn’t get hit by the cold air going in, instead it is kept warm by the air going out. If you suffer from asthma, then be extra careful, but don’t let the cold stop you. Check with your doctor if you’re concerned. </blockquote>
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<b>Keep moving.</b> If you’ve been out in the cold the first thing you probably want to do when you get back is get into the warm. But in winter, muscles cool down very quickly and you need to make sure you’ve taken some time to get your heart rate down and allowed your muscles to flush out the by-products of exercise before going indoors and slumping onto the couch. Of course, you wouldn’t do that because you’re going to do your cool down stretches first aren’t you! </blockquote>
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<b>Put on enough layers.</b> It’s always difficult to gauge how cold or warm you’re going to feel. Wind chill can make it feel a lot colder than the thermometer indicates. Several thin layers are always better than one thick layer. Modern base layers help wick away sweat and moisture. Wear a hat! </blockquote>
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<b>Don’t stay outside too long! </b>Once you’ve finished training and cooled down properly, get inside and get out of any wet, sweaty clothing. You’re at your most susceptible to infection at this stage, so getting into dry clothes and a warmer environment can help reduce the risk. </blockquote>
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<b>Watch the light!</b> I know it’s stating the obvious, but it gets dark earlier in the winter. Top layers with reflective strips, wrist bands or sashes made from reflective material can all help to make you more visible. Bright clothing helps too. I know that black top looks great, but the yellow one will make you stand out more! A head torch might be useful too. It also makes sense to train during the day if you can. Exposure to sunlight, even in the winter, can stimulate Vitamin D production. </blockquote>
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<b>Eat fruit and vegetables.</b> We all know we should have 5 or 7, even 10 portions of fruit and veg a day but rarely do we manage it. In the winter it’s especially important to make sure you’re getting a good supply of those healthy minerals and vitamins that help fight colds. </blockquote>
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<b>Get the app! </b>There are plenty of free weather apps available for smart ‘phones these days. You can get alerts or forecasts sent to you via email or text message. You could try a web service called “<a href="https://ifttt.com/" target="_blank">If This Then That</a>”. It will allow you to send alerts to your ‘phone if it’s going to rain or the temperature drops. </blockquote>
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<b>Beware the ice!</b> There will be some days when it’s just not a good idea to go out. This is especially true when there’s ice about. If you’re determined to get some fresh air, then why not think about walking rather than running. You’ll have more time to spot those slippery bits of pavement and road surface. </blockquote>
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Remember, every person is unique. just because your training partner or the guys down the gym refuse to wear anything more than a vest and shorts for their runs, you don’t have to prove you’re just as hardy. Everyone has a different level of sensitivity to temperature and you need to find your level of comfort rather than following someone else’s.<br />
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Training outside in the winter can help strengthen your immune system, raise your pulse rate and thereby increase your calorie burn as your body counteracts the cold.<br />
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Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-84018283532692902902017-08-23T08:00:00.000+01:002017-08-23T08:00:04.954+01:00Sports Massage and the Runner<div class="" style="line-height: normal; margin-bottom: 5px;">
<span style="font-family: inherit;">On April 23rd between 30,000 and 40,000 people lined up at the start of the London Marathon. Around 50% will have finished inside 4 hours. By the time they’ve completed their training and the 26 miles (and the extra few hundred yards) they will probably have gone through at least 4 pairs of trainers. </span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">Throughout all the training some will have spent time on the treatment table getting regular massages and treatment. So what can massage do for the runner?</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">Sports massage has a number of physical benefits from improving the permeability of soft tissue to allow for faster delivery of nutrients and faster removal of waste products, to helping increase flexibility in muscles and other soft tissue structures that it turn can help you become a more efficient runner. </span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">Sports massage also involves a number of techniques that help breakdown scar tissue that arises from muscle injury, improving the tone of muscles. Add to that improving circulation, relieving relief and relaxation, and you have a growing number of reasons why a massage is not just a luxury to be enjoyed once in a while but might actually be a benefit on a more regular basis.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;"><b class="">What, when and how often</b></span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">Everyone is different, but if you’ve been inspired by the marathon, actually running the marathon or just taking up jogging or running, then consider making a regular massage part of your training plan. If you’re just starting out, then a good massage can help identify areas where the muscles are tight or short, or maybe weak and not working as well as they could. If you’re deep into training, then massage can help keep you healthy, reducing the potential for injury.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">A massage once a week might be too difficult to work into your diary but once a month or every six weeks can be a good pattern to adopt. A massage in the final week before the marathon is a good idea, and don’t forget to book an appointment for a post-event session too! After running 26 miles your muscles will need a bit of attention!</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">And if you’re not running the marathon? Well Sports Massage can be of great benefit to everyone whatever exercise you do, and even if you don’t!</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">Try it and see.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;"><b class="">10 odd facts from the London Marathon</b></span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The London Marathon is the Guinness World Record's largest annual fundraising event in the world. The event itself holds a Guinness World Record for one-day charity fundraising, a record it has broken each year for the past nine years.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The millionth runner crossed the finish line in 2016.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The London Marathon is shown on television in nearly 200 countries around the world.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The fastest MP to date was Matthew Parris, who ran a crowd-pleasing 2:32:57 in 1985.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The speediest female celebrity was Nell McAndrew, clocking an impressive 2:54:39 in 2012.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The hottest marathon day was in 2007 when temperatures peaked at 21.7°C.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The coldest race day was a chilly 7.6°C in 1994.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">The most common occupation for people running the marathon is teaching.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">250 tubs of petroleum jelly, 200 bottles of baby oil, 2,000 plasters and 50,000 Lucozade Sport gels were available on the route last year.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">At mile 10.5, the route passes within 300 yards of the Mayflower, the pub where the Pilgrim Fathers met for a quick pint before they sailed to America.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;"><b class="">How much do you stretch before and after a run?</b></span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">Go on, be honest now, how much stretching do you actually do? Many of us, even those committed to exercise, probably don’t stretch as much as we need to. It almost feels like time wasted when what we really want to do is getting out there and run or ride the bike or just get through our workout at the gym. We simply don’t have the time to stretch for 15 or 20 minutes before or after our exertions.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">But the older we get the more we begin to understand that stretching is vital if we’re going to maintain flexibility and recovery from exercise.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">So how do you make the most of your time spent stretching? Well, before exercise it’s best to warm up and do some dynamic stretches. After exercise, a few simple static stretches can help reduce muscle soreness and stiffness and help maintain flexibility.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">It doesn’t have to be complicated or time consuming. For example, a good dynamic warm up stretch that engages large groups of muscles in a single movement would be a lunge with upper body rotation and arm raises. That just about engages every major muscle in your body and doing 10 or 12 of these takes very little time.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">After exercise, a few simple static stretches of the muscles that have been most used can help keep them healthy. Hamstrings and calf muscles can be stretched in one move by flexing at the waist, rotating the pelvis forward. You will probably feel a stretch going all the way up the backs of your legs if you perform this move properly.</span></div>
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<span class="" style="-webkit-font-kerning: none; font-family: inherit;">So, make sure to add some simple stretching to your exercise or training programme. You will definitely feel the benefit.</span></div>
Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-22723997019833406492017-08-16T08:00:00.000+01:002017-08-16T08:00:27.891+01:00Tight or Toned?New to the gym or an old hand, eventually you’ll become aware that some muscles might feel a bit “tighter” than they used to. You might be tempted to put this down to getting more toned, but that might not be the whole story.<br />
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Muscles are meant to operate at a certain length. In fact they are at their optimum power just short of what is called their normal resting length. When a muscle is overworked it can become shortened and tight. This has a knock-on effect throughout the body. Muscles work in pairs or groups and tight, shortened muscles can stress their partner muscles and are themselves under stress.<br />
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At the most basic level muscles work in pairs. When one muscle contracts the muscle that performs the opposite motion relaxes so that movement can occur. They need to be balanced in order to work at their most efficient. Any tightness on one side will upset this balance. But it’s not only the opposing muscle that can be affected. That pain you sometimes feel in the back of your shoulder when you’ve been running for a while-well it might just be that it’s related to a problem with the opposite hip, or even the ankle.<br />
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Tight muscles on one side can lead to weak muscles on the opposing side. For example, if your job means that you spend a lot of time sitting down, then it’s possible that the muscles that flex the hip can become shortened and tight. This in turn can lead to the muscles that extend the hip becoming weak. Typically in the hip that means the big gluteal muscles become weak and the knock-on effect of that is that your hamstring muscles have to compensate for the the weak gluteal muscles and they in turn become stressed and overworked!<br />
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So, what’s the solution? The first thing you need to understand is that there is no point trying to strengthen a weak muscle until you’ve got the shortened muscle back to its proper resting length. In fact strengthening the weak muscle will probably make the problem worse because now you will have tightness on both sides of the joint, reducing flexibility and preventing fluid movement. Manual therapy like massage and manipulation can help relax the stressed muscles and restore length. Simple, regular stretching can help maintain the new length and begin to restore range of motion and flexibility. Left untreated, shortened muscles can lead to tendonitis, a condition that causes inflammation and pain in the tendons.<br />
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There are a few simple things you can do to help yourself as you train. Firstly, always make sure you have good posture when you exercise. Shoulder back, round and down, was a phrase my PT always used to repeat as we did various circuits. Don’t just use the mirrors in the gym to admire your biceps, use them to check your posture! You can support your posture too by making sure you include exercises that work the muscles groups you can’t see in the mirror. You could even ask someone to do a simple posture check by looking at the alignment of your ear, shoulder, hip and ankle. Most postural problems lead to a forward head position.<br />
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Secondly, make sure you are doing some work on flexibility and that you are stretching regularly. We all know that stretching can be the tedious part of any exercise routine, but we can’t ignore its importance.<br />
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Thirdly, build rest and recovery into your training plan. Vary your training load and intensity so that your body gets to recover. And last, but not least, stay hydrated. A 2% fall in hydration can lead to up to 20% loss of function, so keep drinking plenty of water as you train.<br />
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Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-71975201679282787072017-08-09T07:46:00.002+01:002017-08-09T07:46:58.742+01:00Rest & Recovery<i>This is a short piece I wrote for our summer newsletter at the gym where I run a weekly clinic.</i><br />
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How is your fitness plan going now we’ve landed in the summer holidays? Are you still putting in the miles, hitting PB’s, upping the intensity, or are you taking a break, relaxing, making the most of time away from the treadmill? You might, if you've opted for the latter approach, be feeling a twinge of guilt. You might feel that if you don’t get out and do something you’ll suffer for it when you get started again, or maybe you worry you’ll never get started again.<br />
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Perhaps you’ve just joined the gym, having decided it’s time to get fitter, lose some weight or simply get active. You’re hitting the cross-trainer, looking at classes and are all pumped-up about the new you waiting to be revealed!<br />
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Whenever you start a new exercise or fitness routine one of the sometimes overlooked aspects of the plan is rest and recovery. Along with all those stretches we’re supposed to do pre- and post- training, but never quite find the time to actually do, taking rest and recovery seriously simmers away on the back burner of our training schedules. Someone somewhere once mentioned periodisation, but we can’t remember what it is and why it’s important. And anyway, we’re too busy training to take time off.<br />
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But here’s the thing, over-training can create chronic conditions that can be hard to treat and can even lead to not being able to participate in training the way you want to. Typical over-use injuries include things like tennis elbow, runner’s or jumper’s knee, tendonitis, joint and muscle pain. As their name implies, they come on slowly over a period of time rather than suddenly, although some show up suddenly with an acute pain, the symptoms have probably been developing over weeks and months. Some seem to cure themselves, usually because our technique improves, but others simply persist.<br />
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The good news is that if you factor in proper rest and recovery, you can reduce the risk of suffering a chronic injury. Soft tissue therapy can also play an important role in helping keep tissue healthy and helping in rehabilitating injuries when they occur.<br />
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Periodisation doesn’t have to be complicated and it isn’t just for competitive athletes. Everyone can develop a simple approach to keep themselves motivated and energised about their training. A simple plan might be set out over three months and broken down into three four-week cycles. Weeks 1-3 might be you’re most intense training patterns and the fourth week would be a light, rest and recovery week. You could even schedule a Sports Massage for week 4!Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-19363060934392415512017-05-04T10:33:00.002+01:002017-05-04T10:33:18.762+01:00Stretching and the role of fasciaI'm working my way through <i>Fascia in Sport and Movement</i>, edited by Robert Schleip, reading the chapter on fascia as sensory organ. Fascia is a fascinating subject. It is an intricate and historically overlooked anatomical and physiological feature. These days there is more and more research being undertaken to explore the nature and function of what appears to be the largest sensory organ of the body (p31).
I'm just reflecting on this paragraph:
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Stimulation of the Golgi receptors tends to trigger a relaxation response in skeletal muscle fibres that are directly linked with the respectively tensioned collagen fibres. However, if tendinous extramuscular are stretched in a condition in which they are arranged in series with relaxed muscle fibres, then most of the elongation will be 'swallowed' by the more compliant myofibres. In this way, the respective stretching impulse may not provide sufficient stimulation for eliciting any muscular tonus change (Jami, 1992). A practical conclusion may be that a stretching impulse, aimed at reaching the tendinous tissues, may profit from including some moments in which the lengthened muscle fibres are actively contracting or temporarily resisting their overall elongation. (p33)</blockquote>
My first thought was isn't this what we do when we apply MET or PNF? In both those approaches to stretching we use the Golgi Tendon Organs to elicit a relaxation phase in the target muscle by contracting it against a resistance and 'turning off' the muscle spindles. But maybe this also explains why, having stretched a muscle it can quickly return to its shortened state. Perhaps it is simply not enough to target the compliant fibres, needing in addition to target those less compliant fibres.
I don't know, and it definitely needs more thought. There are many other possible reasons why, after applying all our techniques and skills, some tissue simply refuses to respond as we would like. But it does look like a deeper understanding of an appreciation for the role of fascia could open up a whole new world of possibilities!<br />
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One of those possibilities that came to mind was to experiment with stretching by adding a small degree of stretch during the contraction phase. It's just a wild idea at the moment, and may prove totally fruitless. Even as I think about it, I wonder how you could do this in practice-stretch an already contracting muscle. I shall have to experiment on myself!Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-40737835167385259412017-04-22T08:43:00.004+01:002017-04-22T08:43:59.358+01:00A germ of an ideaOkay, so as you know I'm off to the London Marathon tomorrow (Sunday 23rd April). It's my second year working with Against Breast Cancer, and as I said in the previous post, it's quite a small group of runners. And that got me thinking.<br />
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How many smaller charities have runners, maybe only one or two, raising money for them at this year's event? I don't know the answer to that question, I'm guessing someone, somewhere does, but it's not me. I'm pretty sure that although there might be a welcoming committee to cheer these runners home, I'm not sure how many will get the good bags and an offer of a post-event massage at the end of their 26 mile run.<br />
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So what if we got together and provided that service for a group of charities? Under some sort of collective banner a small team of 6 or 8 therapists could probably treat 100+ runners that might otherwise not get the opportunity.<br />
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I'm not sure how to organise something like that, but if a group of charities worked together I'm sure we could get a big enough marquee sorted. It's worth some thought.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-86021190969854397592017-04-15T07:47:00.001+01:002017-04-15T07:47:15.292+01:00Why I work for nothingOn the 23rd April 2017 I will once again be dragging my massage couch through St James Park to set up in a gazebo and prepare to treat a group of charity runners at the London Marathon. I've done this for the last 5 years and always as an unpaid volunteer.<br />
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Each year I see offers of 'paid work' but for me it's become somehow important that I give up my time for free. Each runner I treat has put themselves through some sort of training programme that has resulted in them just having run 26 miles. It might have taken them anything from 4 to 6 hours to complete the course. They've done it to raise money, often for a cause close to their hearts because of family loss or circumstances or experience.<br />
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Don't get me wrong, I don't have a problem with people getting paid to do what I choose to do for free. It is, after all, my choice. It doesn't make me or them better. It's a choice. I do get a bit annoyed when I discover that having volunteered some pull out of the volunteer role because a paid role has come along. That leaves the charity looking for volunteers in the difficult position of casting around for last minute replacements, and quite frankly I find that unacceptable.<br />
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This year I'm working with Against Breast Cancer again. We'll be somewhere in St James Park and I'm not sure how many runners they have in this year's event and how many will come for a post-event massage, but we'll be there, ready and waiting.<br />
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And if your chosen charity hasn't got post-event massage available and you fancy a 10 minute rub-down, then why not come and find me and I'll see what I can do.<br />
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<br />Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-34040960810419305712016-11-30T08:37:00.000+00:002016-11-30T08:37:04.942+00:00Slings and ChainsThere's been a lot of talk over the last few years about fascia. We've had symposia about it and there seems to be some interesting research taking place. We no longer see it as just a layer of tissue but as something more significant than that. It seems quite logical when you think about it that this cling-film like material that is wrapped around muscles and bones and that blends together to form something of a network throughout the body, should actually be playing a role in the complex systems of movement and posture.<br />
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Now, I'm no expert, so I'll leave the technical stuff to someone else, but as a therapist I'm fascinated by the relationships that exist through this fascial net, as I am about the non-isolated relationships between muscles. When we learn our basic anatomy it's usually done muscle by muscle as if they work in isolation. But we soon realise that this is not the case. Very quickly we discover agonist and antagonist as one relationship, then we begin to learn about co-contraction, eccentric and concentric contractions, synergists and stabilisers. Next we might start to think about movement patterns. Not just getting up from a seated position or taking a walk but about what happens when we kick a ball or hit a tennis serve.<br />
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These patterns are a series of complex interactions as muscles contract to produce movement at a joint or to stabilise a joint during movement. Suddenly our origins, insertions and actions of isolated muscles simply won't do the job of informing our understanding of these patterns.<br />
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Of course, from a therapy point-of-view, it's only when these patterns breakdown and cause an injury or a limitation that we tend to get involved. It's then that we start the detective work of trying to figure out what's going on and what we might be able to do to help fix it. I've never bought into the slightly "mystical" approach that I've seen some therapist apply. Personally I prefer to think a little more logically and dare one say scientifically about what I'm doing. For me there's nothing mysterious about a pain in the shoulder starting from the ankle on the opposite side when you understand a little more about how muscles interact and how fascia responds. It makes logical sense.<br />
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This is where myofascial slings are helpful as are muscle chains. Muscle chains got mentioned to me the other day and I'd not heard the term before, so I decided to do a quick bit of research. There's a lot more to be read, but at it's most basic a muscle chain simply traces the relationship between muscles and they cross joints or share attachment site. For example, think about the relationship between tibialis anterior and latissimus dorsi on the opposite side. TA shares and attachment site with peroneus longus, which in turn shares a site with bicep femoris. Follow this hamstring muscle and you'll find a connection with GMax via the sacrotuberous ligament. GMax and LD share an attachment via the thoracolumbar fascia. You could trace gastroc in a similar way. In fact, when a client comes to me complaining of tight hamstrings, I often check gastroc first with a simple test. Usually, even if the hamstrings are tight, there's tightness in the calf too. Where the client first feels this in a forward bend can be a clue as to where the primary problem might lie.<br />
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So, if you're just starting out in therapy remember to think about muscles in relationships and in movement patterns and not just in isolation, and maybe try to find a subtle way to get your gym bunny clients to understand that too!Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-53751420205956965192016-02-19T09:03:00.001+00:002016-02-19T09:03:21.585+00:00The new muscle on the blockSo, last year as I recall we were told about a new ligament in the knee and now we find out there's a new muscle in the quadriceps! They've given it the name tensor VI, or TVI. It lies between VL and VI and apparently the <i>TVI combined with an aponeurosis merging separately into the quadriceps tendon and inserting on the medial aspect of the patella.</i><br />
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According to the abstract I read (you can find it <a href="http://www.ncbi.nlm.nih.gov/pubmed/26732825" target="_blank">here</a>) this new extensor was found in all the lower limbs investigated. What caught my eye was the insertion on the medial aspect of the patella. Thinking out loud I wondered whether further research would point to the influence this newly discovered extensor might have on patella tracking. I don't know, and it would obviously depend on how that medial attachment relates to the patella tension and the quadriceps in general. That's something for the clinicians and sports science folk to play with!<br />
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It is quite amazing that with all the anatomy studies that have been done that we're still finding new stuff, but I guess we're more complex that we probably imagine.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-51402382448867207992016-01-14T09:57:00.001+00:002016-01-14T09:57:29.327+00:00Tennis Anatomy<div class="separator" style="clear: both; text-align: center;">
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I decided to read this book for two reasons. I'm both a therapist and a tennis player, so the book appealed to both aspects of my thinking. The book has value to both, but maybe not as much for the therapist as for the player.<br />
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As a therapist, the value of the book lies in the detailed analysis of which muscles are at work in the full range of tennis shots. Knowing where to focus your attention when working with any sports person can be a challenge, and of course it differ from sport to sport. As well as tennis players I get to treat a range of sports people from runners to rugby players.<br />
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The books provides a general introduction to how a tennis player moves and how they adapt to different surfaces and also how different styles of playing influence the way muscles are used. There's also a useful section at the end of the book on movement patterns that could be used to provide the basis for rehabilitation exercises, and a chapter covering common tennis injuries and stretches. The chapters in-between look at specific areas of the body (shoulders, wrists, core, etc). Chapter 8 is focussed on rotational strengthening.<br />
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Each chapter looks at the anatomy of the area, how it is used in tennis and then offers a series of exercises related to strengthening that area.<br />
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The reface makes the aim of the book very clear:<br />
<blockquote class="tr_bq">
<i>This book is written for serious competitive and recreational tennis players... In this book, we highlight the different muscles groups involved in each of the strokes and show you how to best train those specific muscle groups as part of a comprehensive approach to tennis-specific training.</i></blockquote>
The book certainly delivers on that level! From a therapy perspective, the book's value lies in increasing one's understanding of the mechanics of tennis. How you apply that knowledge is up to you!<br />
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My verdict: Not really a therapy book, but a useful read if you're dealing with racket sports.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com1tag:blogger.com,1999:blog-548315535791029400.post-23543519876332496962015-08-08T11:48:00.000+01:002015-08-08T11:48:01.472+01:00An Alternative Way to HIT<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-LtTNLFfVsKU/VcXcV9l9abI/AAAAAAAABx8/QGTTAf-Nvag/s1600/Screen%2BShot%2B2015-08-08%2Bat%2B11.38.33.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="189" src="http://4.bp.blogspot.com/-LtTNLFfVsKU/VcXcV9l9abI/AAAAAAAABx8/QGTTAf-Nvag/s200/Screen%2BShot%2B2015-08-08%2Bat%2B11.38.33.png" width="200" /></a></div>
Came across this <a href="http://well.blogs.nytimes.com/2015/07/29/a-way-to-get-fit-and-also-have-fun/?WT.mc_id=2015-KWP-INTL_AUD_DEV&WT.mc_ev=click&ad-keywords=IntlAudDev&kwp_0=32104&kwp_4=184140&kwp_1=172541&_r=0" target="_blank">article</a> via Facebook of all places! Amazing what slips through amid the pictures of angry looking cats and banal so-called "Only for geniuses" rubbish.<br />
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It's about a study done in Denmark looking at high intensity interval training that developed into a different routine. The researchers suggest a 30-20-10 approach where you do low intensity for 30 seconds, moderate for 20 and all out for 10 before resting and repeating. They call it 10-20-30, probably because that is easy to say and it scans nicely.<br />
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The results are interesting too, although there is a minor warning about injuries in the test group. Using runners the results showed an improvement in 5k times and a lowering of blood pressure plus other positive health markers. Interval training does improve endurance, so some of these affects are not a direct rest of the specific intervals used, but rather the impact of interval training in general.<br />
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The upside of the programme might lie in its simplicity. Some interval programmes can get quite complicated, so anything that makes it easy to do and easy to repeat is a good thing. If it makes it fun then all the better.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-80726792988880645422015-06-12T09:09:00.002+01:002015-06-12T09:09:27.532+01:00COPA 2015So I trundled off the the ExCel again yesterday for the annual COPA Practice Show. It's a range of exhibitors and talks aimed primarily at Chiropractors, Physio's and Osteo's. There's stuff there for other maul therapists and soft tissue specialist too.<br />
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This year there was a lot more exercise equipment on display and a few stands about nutrition. There were companies with software for handling client appointments, designing exercise and rehab programmes and assorted orthopaedic aids and supports.<br />
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I had a good chat to one or two interesting folk and came away with an array of leaflets, booklets, samples and even a t-shirt this year! I didn't have too much time this year, so I wasn't able to take in any of the talks and seminars.<br />
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In the next few days I'll sort through all the stuff I picked up and decide what is worth following up at this time and what can go straight in the bin. I found some interesting looking CPD courses that might be useful, and there are some that I didn't visit but remember them from previous years and was reminded that they too might be worth a look. Often the courses run at weekends, or so it seems, and when you're involved in a sport at weekends it makes these courses difficult to fit into a schedule of fixtures. I have the same problem with my tennis coaching qualifications where the courses are almost exclusively weekends, just when I'm busy on the touchline!Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-55077886930311260842015-05-21T10:15:00.001+01:002015-05-21T10:15:14.624+01:00Agility trainingOk, so not very therapy orientated, but I'm not just a therapist!
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An interesting agility drill for <a href="http://rugbyfitnesstraining.com/blog/measuring-agility-rugby-fitness-training-agility/" target="_blank">rugby</a>. I think it might be good for tennis players and other racket sports too.<br />
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I have another drill I picked up from a tennis website that uses two cones around which you shuffle in a figure of eight. With this drill you always face forwards so you have to use small side-steps as well as forward and backward movements.<br />
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I sometimes do it using the tramlines as a guide during a warm up routine. This rugby drill could be done using the baseline and service line. Although I might adapt it if I thought running backwards on a hard court was dangerous!Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-57769836403448293332015-05-18T17:14:00.000+01:002015-05-18T17:14:04.625+01:00Are all athletes healthy?There was an interesting little piece in <i>The Times</i> today (May 18th 2015) about the incidence of heart issues in elite athletes. The headline was a bit alarming, suggesting that thousands of athletes are at risk of a serious heart problem. When you get into the statistics a study of Italian Olympic aspiring athletes found around 7% had some sort of heart problem that was potentially life limiting. Taking the figures another way, it has been suggested that had screening been used to stop participation, a large number of athletes might well have been prevented from taking part.<br />
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Now this is serious stuff. Who can forget the scenes a few years ago in the Premier League when Fabrice Muamba collapsed and the recent news of the death of a footballer in Europe and a rugby player here in the UK. So any move to increase both awareness of conditions and applying a rigorous testing process for high level athletes in any sport is a bit of a no-brainer. The big question is at what point do you actively intervene and stop someone playing or taking part?<br />
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As a club therapist at a fairly low level of competitive rugby (we just got promoted to tier 7 if I've got my league structure correct), I wonder what we can do to help our players be as aware as possible of their health. Even a very simple screening process including body fat% and blood pressure might be a worthwhile procedure.<br />
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The thing is, we might well do a fitness test at the start of pre-season training and measure it again as the season progresses, but being fit does not presume being healthy. The two can even be mutually exclusive.<br />
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The article in the paper is a timely reminder that we should take health in sport just as seriously as we should be taking it in everyday life. Personally my hope is to be as fit and as healthy as I possibly can be for as long as I can be.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-57034821788219743172015-04-02T18:21:00.002+01:002015-04-02T18:21:26.577+01:00Return to Play Predictors for Hamstring StrainsNot sure where I found this, but it adds another dimension to the return to play discussion.<br />
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The following have been found to be significant predictors of length of recovery:<br />
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<b>Higher V.A.S at the Time of Injury:</b> high correlation (r=0.77) between pain, measured by visual analog scale, and days lost from competition. Interestingly, in this study pain was a more accurate prognostic indicator than clinician’s assessment.<br />
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<b>Recent Past History of Hamstring Injury (Within 12 Months):</b> within the last 12 months were 4.2 times more likely to take greater than 3 weeks to return to play.<br />
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<b>Time to Walk Pain Free:</b> athletes that took longer than 24 hours to walk pain-free with a normal gait pattern where 4 times more likely to take longer than 3 weeks to return to play than those who did not.<br />
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<b>Location of Strain (Medial vs. Lateral):</b> site of injury i.e. biceps femoris, was a significant predictor of longer recovery time. Biceps femoris strains being 2.3 times more likely to take longer than 3 weeks to recovery.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-32316913749363546282015-04-01T15:33:00.002+01:002015-04-01T15:33:13.697+01:00Return to play strategies for sports injuriesI was doing a bit of research about assessing players for return to play after injury and came across an article from the <i>Clinical Journal of Sports Medicine</i> in 2005 looking at return to play after muscles strains. In my first year as a therapist with a local rugby club I've found myself having to deal with muscle injuries and helping a player decide when they are ready to return to play.<br />
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Every player and every injury is subtly different, but there are of course some general principles that apply. Normally I assess muscle strength and pain-free ROM as the basic tools for the decision. Of course some players make their own decisions, as do many athletes!<br />
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The approach you take to return to play strategies will broadly speaking be either a conservative approach, i.e. erring on the side of caution to avoid recurrence of the injury, or looking for an earlier return without being reckless. The paper I was reading provided a table looking at the factors that could affect early return or a more cautious approach.<br />
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<span style="letter-spacing: 0.0px;"><b>Factors Indicating a More Conservative Approach</b></span></div>
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<span style="letter-spacing: 0.0px;"><b>Factors That May Allow More Rapid Return to Play</b></span></div>
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<span style="letter-spacing: 0.0px;">Persisting strength deficit</span></div>
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<span style="letter-spacing: 0.0px;">Strength equal to uninjured side</span></div>
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<span style="letter-spacing: 0.0px;">Persisting flexibility deficit</span></div>
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<span style="letter-spacing: 0.0px;">Flexibility equal to uninjured side</span></div>
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<span style="letter-spacing: 0.0px;">Inability to complete full training without pain or limping</span></div>
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<span style="letter-spacing: 0.0px;">Ability to do all functional activities at training</span></div>
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<span style="letter-spacing: 0.0px;">Large area of abnormal signal on imaging</span></div>
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<span style="letter-spacing: 0.0px;">Normal ultrasound and/or MRI scan</span></div>
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<span style="letter-spacing: 0.0px;">100-m sprinter or team player in high-risk position (Australian footballer, rugby outside back, wide receiver, outfield soccer player)</span></div>
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<span style="letter-spacing: 0.0px;">Team sport player in low-risk position (e.g., offensive lineman, goalkeeper, rugby forward, basketball player)</span></div>
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<span style="letter-spacing: 0.0px;">Older player<br />
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<span style="letter-spacing: 0.0px;">Younger player (but with experience of playing with injury)<br />
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<span style="letter-spacing: 0.0px;">Early stage of season</span></div>
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<span style="letter-spacing: 0.0px;">Playoff or must-win game with no adequate replacement player</span></div>
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<span style="letter-spacing: 0.0px;">Strain in high-risk location (biceps femoris, central tendon of rectus femoris, medial head of gastrocnemius, adductor longus or magnus)</span></div>
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<span style="letter-spacing: 0.0px;">Strain in low-risk location (semimembranosus, vastus muscles, lateral head of gastrocnemius, gluteal muscles)</span></div>
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<br />Some of the points are quite interesting. For example, the difference of approach depending on the position in a team setting, or the location of the strain.<div>
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The table suggests that simply taking into account strength, flexibility and functional activity should not be the only things to consider. </div>
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As a therapist I'm often under pressure from both the player and coach to pass them fit as soon as possible, but this table gives some weight to choosing to be more conservative when other criteria are applied.</div>
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<br /></div>
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I found the original article here: <i><a href="http://numovesphysiotherapy.com.au/wp-content/uploads/2014/02/Orchard-et-al.-2005-Return-to-play-following-muscle-strains.pdf" target="_blank">Return to play following muscles strain</a></i></div>
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Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-37888942235940216002015-03-28T06:56:00.000+00:002015-03-28T06:56:35.362+00:00Identifying SLAP Lesions<a href="http://www.thesportsphysiotherapist.com/identifying-slap-lesions-the-diagnostic-accuracy-of-clinical-tests/" target="_blank">Here's</a> an interesting short piece about the usefulness of some clinical tests for SLAP Lesions.<br />
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If like me, you see a range of shoulder injuries, then knowing some of the basic clinical tests you can do to get an idea of what's going on is always helpful. This article on the The Sports Pysiotherapist's website is a useful discussion of some, but not all, the tests.<br />
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As a Sports Massage practitioner I'm not a clinician, but that doesn't mean I can stop learning about these things!!Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-6334632429101428022015-03-19T08:07:00.001+00:002015-03-19T08:08:47.156+00:00Injuries and recovery in sport: The impact of smokingI'm coming to the end of my first season looking after an amateur rugby club and I have to say it's been an interesting 9 months so far! We've had a few blood injuries, two that needed stitches. One of those was a quite spectacular nose injury that required 14 stitches.<br />
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Most injuries were less dramatic and were a mix of impact, overuse and over-exersion. Ligaments, tendons and muscles all came in for a fair battering and as the season unfolded the amount of tape on shoulders and ankles seemed to expand exponentially.<br />
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I've been trying to read as much as I can about injuries and recovery and rehabilitation. I've been looking for courses too, but to no avail. The only short CPD courses I can find run at the weekend and I'm pitch-side on those days.<br />
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One of things that I've been thinking about a little is the impact that smoking might have on recovery and rehabilitation. A number of the players smoke, and I was wondering what effect this was having on their ability to avoid injury and to recover from injury.<br />
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There are obviously a lot of studies that have demonstrated the various links between smoking and diseases such as cancer and cardiovascular issues. As yet I haven't found a lot of data about smoking and injury recovery, although I did come across a couple of studies that show that both bone fractures and ligament sprains take significantly longer to heal in smokers than in non-smokers. That's not unexpected given the impact smoking is known to have on general health.<br />
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Bone fractures can take up to 25% longer to heal and the risk of non-union occurring is 2.3 times higher for smokers. A study of the effect of smoking on recovery after medial ligament surgery in mice indicated a slower recovery process.<br />
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Everyone knows that smoking is bad for you, but if you're involved in sport at any level, then the impact smoking has on your general health is only one factor you should consider alongside the effect it has on your performance and your potential to recover quickly from injury and therefore return to the field of play.<br />
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The two reports I found were:<br />
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<a href="http://www.uphs.upenn.edu/news/News_Releases/2013/03/smoking/" target="_blank">Blowing Smoke: A Meta-Analysis of Smoking on Fracture Healing and Post-Operative Infection</a><br />
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and<br />
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<a href="http://news.wustl.edu/news/Pages/9559.aspx" target="_blank">Cigarette smoking impairs ligament healing, researchers find</a><br />
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There's obviously a lot more reading to do, assuming I can find the information, but it is at least a potentially useful place to start when suggesting that maybe a player should give up smoking if they want to avoid longer than necessary times out of the game.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-90310489616376809172015-02-23T13:41:00.004+00:002015-02-23T13:42:24.084+00:00The Vital Glutes: A Review<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-xeeydGRYyqY/VOssU3o2LoI/AAAAAAAABqo/tdZkjDK4vMA/s1600/Unknown.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-xeeydGRYyqY/VOssU3o2LoI/AAAAAAAABqo/tdZkjDK4vMA/s1600/Unknown.jpeg" height="200" width="142" /></a></div>
It was the second or third week working with a local rugby team that one of the prop forwards came to me by the side of the pitch and asked if I had anything I could put on his aching back. It was a late summer day and the ground was dry, so I told him to lie down on his back and I'd have a quick look. I did a simple stretch of his hamstrings and glutes and asked him to stand up and tell me if anything had changed. To his surprise the pain had gone and he announced to all the other players that it was wonderful, I'd put him on his back, bent him over and fixed his back! It took a while for the laughter and suggestions to die down from that one!<br />
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I did this simple stretch because ever since I trained as a therapist I'd become aware of the connection between lower back pain and tight muscles around the hip. I've seen a number of client respond well to working through this chain of muscles.<br />
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John Gibbons's book "The Vital Glutes" confirms the importance of these muscles in addressing not just power back pain but many other issues that may have a connection to weak or inhibited, misfiring gluteal muscles.<br />
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The book looks at the functional anatomy of both GMax and GMed after exploring muscle imbalance and myofascial slings. There are some really helpful insights for both understanding what might be at the root of a presenting issue and for clinical practice.<br />
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The book also has quite a detailed discussion of the gait cycle in the context of the role of the glutes. At the end of the book there is a section showing a wide range of progressive exercises that can be used with clients in rehabilitation.<br />
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As a Sports and Remedial Massage Therapist I found this book accessible and definitely worth the read. I shall go back through it, picking out useful points and ideas for my practical work with clients. Yes, there are parts that will tax your brain as you try to get your head around things like force and form closure and the gait cycle if you haven't done that sort of stuff before. But it's certainly not beyond the scope of most massage practitioners who studied at a reasonable level and know their way around the anatomy and physiology they learnt as a student.<br />
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For most therapist anatomy is learnt in terms of origins, insertions and action of individual muscles, but muscles don't work in isolation. This book should convince you that understanding the wider picture of movement and the influence of one muscle on another is something in which you should invest some thinking time.<br />
<br />Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0tag:blogger.com,1999:blog-548315535791029400.post-34022216634520597812014-12-22T08:53:00.002+00:002014-12-22T08:53:16.191+00:00PFP Event<div class="separator" style="clear: both; text-align: center;">
<a href="http://4.bp.blogspot.com/-gAsGyZkz4RA/VJfbRRQ1aGI/AAAAAAAABoM/RC5no8CGcUg/s1600/Screen%2BShot%2B2014-12-22%2Bat%2B08.49.39.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-gAsGyZkz4RA/VJfbRRQ1aGI/AAAAAAAABoM/RC5no8CGcUg/s1600/Screen%2BShot%2B2014-12-22%2Bat%2B08.49.39.png" height="82" width="320" /></a></div>
This popped up on my Twitter feed the other day. I was wondering about going, but haven't decided yet. Given the number of people who complain about knee pain, it might be 3 hours well spent!<br />
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Here's a <a href="https://www.eventbrite.com/e/patellofemoral-pain-translating-research-into-clinical-practice-tickets-14944253665" target="_blank">link</a> to the Eventbrite booking page for the seminar.Richardhttp://www.blogger.com/profile/14877422243994973637noreply@blogger.com0